A Health Resources and Services Administration report from 2016 estimates there will be a shortage of 7,080 U.S.-based cardiologists by 2025—the largest deficit of any internal medicine subspecialty. This coincides with a time when the aging baby boomer population is expected to require more and more treatment for cardiovascular disease (CVD).
“It’s essentially a perfect storm,” said Jeremy Robinson, regional vice president of marketing a Merritt Hawkins, a search and recruiting firm for physicians, nurse practitioners and physician assistants.
A perfect storm in that care delivery models will need to be overhauled to battle this tide of CVD, but also a perfect storm that’s driving hospitals and medical practices to do more than ever to woo qualified providers.
“The incentives that people are having to leverage today to recruit are almost unprecedented,” Robinson said. “We’ve never had to do this.”
Invasive cardiologists ranked No. 1 of all subspecialties with an average starting salary of $590,000, according to Merritt Hawkins’ 2018 report. The figures are based on a sample of 3,045 physician and advanced practice provider (APP) search assignments that was conducted from April 2017 through March 2018.
The report reflects starting salaries but not total compensation. Providers may earn additional dollars through productivity and quality incentives, while this data reflects the base salaries and signing bonuses that health systems are using to attract physicians.
What’s behind the trend?
The basic economic principle of supply and demand is driving the high starting salaries and signing bonuses offered to cardiologists—particularly on interventional side. Their $590,000 starting salary far outpaces the noninvasive cardiologists’ $427,000. Signing bonuses across all of cardiology were $37,500, Robinson said, about $4,000 more than the average physician.
“With cardiovascular disease on the increase and a shrinking candidate pool I think it’s going to do nothing but continue to put additional pressure from a recruitment perspective,” Robinson said.
He added the marketplace is so competitive that cardiologists who are just coming out of training may be offered a starting salary within a few thousand dollars of someone with 20 years of experience. The difference in total earnings usually stems from incentives offered through various compensation models, Robinson said.
Demand for APPs also growing
According to the report, Merritt Hawkins conducted more searches for nurse practitioners and physician assistants in the past year than any of the previous 24 years. The company also found the average starting salary for nurse practitioners increased to $129,000, the highest ever and up from $107,000 in just 2014-15.
APPs are increasingly becoming part of multidisciplinary care teams, including in cardiology, and are seen as one potential tool for softening the impact of physician shortages.
“We recruit across every medical, surgical, behavioral and dental modality and nurse practitioners are our third-most requested discipline … and I think that speaks volumes to the shortages on the physician side that we’re facing,” Robinson said. “Hospitals and practices alike are leveraging nurse practitioners and PAs to a greater degree so that everyone is practicing at the top of their license with the thought that it’s going to improve quality, patient satisfaction (and) access as well.”
More part-timers accepted
Cardiologists’ desirable credentials have resulted in at least one other trend, Robinson said. More health systems are willing to deal with irregular schedules and part-time physicians because they can’t afford to turn away too many qualified candidates.
“You think about how taxing that is on the operations side to be handling more atypical calendars but they’re doing it out of necessity because if they can attract and retain somebody who’s providing high-quality care, then organizations are really bending over backwards to try to accommodate people,” Robinson said.